Provider Demographics
NPI:1528632767
Name:BRADSHAW, ANDREW CHRISTIAN (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CHRISTIAN
Last Name:BRADSHAW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 HILLSDALE AVE APT B
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-2762
Mailing Address - Country:US
Mailing Address - Phone:201-321-9776
Mailing Address - Fax:
Practice Address - Street 1:7901 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-3268
Practice Address - Fax:718-334-3441
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program